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Extracorporeal life support for cardiac arrest in a paediatric emergency department

So-phia Chew, Lai Peng Sharon Tham1

  • 1Department of Emergency Medicine, KK Women's and Children's Hospital, 100 Bukit Timah Road, Singapore 229899. tham.lai.peng@kkh.com.sg.

Singapore Medical Journal
|March 26, 2014
PubMed

Insights

Early extracorporeal membrane oxygenation (ECMO) in the pediatric emergency department successfully resuscitated a child with fulminant myocarditis. This life-saving intervention highlights ECMO

Area of Science:

  • Pediatric Critical Care Medicine
  • Cardiology
  • Emergency Medicine

Background:

  • Extracorporeal membrane oxygenation (ECMO) initiation in the emergency department (ED) is infrequent.
  • Acute fulminant myocarditis can lead to rapid hemodynamic deterioration in children.

Observation:

  • A nine-year-old girl presented with acute fulminant myocarditis and pulseless ventricular tachycardia.
  • Standard resuscitation measures failed to restore spontaneous circulation.

Findings:

  • ECMO was initiated promptly in the pediatric ED, successfully resuscitating the patient.
  • The patient received ECMO for nine days and recovered with normal neurocognitive function.

Implications:

  • Early ECMO in the ED can be a life-saving intervention for pediatric in-hospital cardiac arrest.
  • This case demonstrates the feasibility and benefit of ED-initiated ECMO for reversible causes of cardiac arrest.
  • Highlights the critical role of advanced life support in pediatric emergencies.

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